Request for Duplicate Certificate of Registration
WORLD CLASS MINIATURE HORSE REGISTRY, INC.
12009 Stewartsville Rd.
Vinton, VA  24179

Tel./Fax: (540) 890-0856

Please provide as much information as known

Horse's Name
Registration Number if known or available WC:
Other Registry #s if applicable
Foaling Date-approximate  
Sex:
Mare, Stallion, Gelding Ht. "

Body Color
Pinto Appaloosa
Mane  Tail Color

Breeder if known:

Fees: Certificate Replacement: $10      
Update to Permanent $5                             If the horse was not registered as permanent and became eligible for permanent   
Measure from last hair of mane                    registration during the period in which the certificate was not available.
to level ground. Height: "
Membership-must be current $32:            with subscription USA Only to Equine Journal.    $5 coupon available
Membership without subscription $25:     without subscription (all countries)  $5 coupon available

                                                                         Names on Membership may include spouse or partner at no extra fee.
                                                                        


Name:
Farm Name (if any):
Address:
City: State (or Providence if foreign country):
Zip:   Country:
email:Telephone:

I am the legal owner of the horse mentioned above.  Bill of sale required if not the owner of record.
I certify that the actual certificate was lost, stolen, or destroyed.   
     
Mail to the above address along with appropriate fees in US Funds only. Foreign Countries write US beside the amount
     for personal checks.